PTSD is in no way an easy diagnosis for the patient, the provider, or the therapist. It is a diagnosis developed at the border of our capacity to handle extreme stress, a marker diagnosis denoting the limits of our capacity for functioning in the stress of this modern world. For both individuals and society, PTSD marks the limits of our available compassion and our capacity to protect ourselves from the dangers of the environment and other humans. PTSD is often a chronic disease, forming at a place where mind sometimes no longer equals the brain, a point at which individual patient requirements often trump theory and belief. There are treatments for PTSD that work, and many that do not. This book presents evidence, rather than theory, anecdote, or case report. Psychological approaches including prolonged exposure, imagery rehearsal therapy and EMDR have a greater than 75% positive short-term response when used to treat PTSD. Yet these treatments vary markedly and have different, even contradictory underlying theory and objectives for treatment. Medications, rarely indicated as primary therapy, can be used to treat symptoms and address comorbid PTSD diagnoses. Treatment of sleep apnea in the PTSD population produces a positive effect on symptoms and a reduction in morbidity and mortality across the span of life. Complementary treatments offer the many individuals chronically affected by PTSD assistance in coping with symptoms and opportunities to attempt to functionally integrate their experience of trauma.

After reviewing the relevant treatment literature, the authors detail how to assess and treat PTSD using a cognitive-behavioral approach. Co mplete instructions are given for planning treatment, as well as for i ntroducing the patient to the various interventions. Nine exposure and stress management techniques are then detailed, including imaginal ex posure (trauma reliving), in vivo exposure, relaxation training, thoug ht-stopping, cognitive restructuring, covert modeling, and role-playin g. Enhancing the books clinical utility are numerous case examples il lustrating how to implement the techniques, as well as explanations of how to cope with common problems and complications in treatment. The final chapter presents detailed outlines of three suggested treatment programs.

This volume brings together the leaders in the field of PTSD research to present an up-to-date summary and understanding of this complex disorder. All of our current knowledge and controversies concerning the diagnosis, epidemiology, course, pathophysiology and treatment are described in detail. The evidence for efficacy for each of the different forms of psychotherapy and pharmacotherapy is reviewed. Particular attention is paid to at-risk groups, including minorities, and coverage of PTSD throughout the world is reviewed as well. The authors present state-of-the-art findings in genetics, epigenetics, neurotransmitter function and brain imaging to provide the most current and comprehensive review of this burgeoning field.

In line with the theoretical elaboration of countertransference in the trauma clinic, this article addresses the therapist's relationship to the strangeness of the trauma, as well as his/her interaction with the cultural difference of the other, who is in this case, the traumatized patient. Thirty-one therapists were interviewed about their subjective experiences, using the methodology of interpretative phenomenological analysis. This article shows interesting subtleties in countertransference reactions to trauma narratives and sheds light on processes indicative of trauma transmission. Therapists interviewed could express experiencing moments of strangeness and inner disquiet; resonance in the defense mechanisms deployed by therapists and by patients at certain moments of the therapy; resorting to disregarding cultural interpretations/generalizations to make sense of an utterly painful situation and put a protective distance with the patients' culture of origin.

This book should be of value to all mental health professionals, researchers, and students interested in traumatic stress, as well as legal professionals dealing with PTSD-related issues.

Posttraumatic Growth reworks and overhauls the seminal 2006 Handbook of Posttraumatic Growth. It provides a wide range of answers to questions concerning knowledge of posttraumatic growth (PTG) theory, its synthesis and contrast with other theories and models, and its applications in diverse settings. The book starts with an overview of the history, components, and outcomes of PTG. Next, chapters review quantitative, qualitative, and cross-cultural research on PTG, including in relation to cognitive function, identity formation, cross-national and gender differences, and similarities and differences between adults and children. The final section shows readers how to facilitate optimal outcomes with PTG at the level of the individual, the group, the community, and society.

Building on this analysis, Brewin provides valuable information on who will be vulnerable to traumatic stress, how to tell whether someone is likely to be suffering from PTSD, why some interventions work and others are ineffective and what could and should be done to help survivors."--Jacket.